Hey /u/cozyessi,

I'm happy to hear that the antibiotics helped. SIBO is tricky and still very poorly understood. I'm going to list some recommendations for maintaining a healthy microbiome below:

FoodThe low FODMAP diet has been shown to be effective at helping prevent SIBO recurrence.In general, you can improve your gut microbiome health by adding fermented foods, such as kombucha, kefir, yogurt, kimchi, to your diet. Fermented foods contain live, beneficial bacteria that can lead to improvements in your gut microbiome. In addition, they contain a lot of compounds formed through the process of fermentation that are beneficial to you and the bacteria already in your gut.

However, as a SIBO patient, some of these may worsen your symptoms. The response to diet is highly personalized and I would recommend you try some of these things to see what improves.Lastly, lifestyle aspects have been associated with features of a healthy gut microbiome. Specifically, some studies have identified links between good sleep quality and exercise with positive improvements in the gut microbiome.

It also sounds like fatigue is something that is bothering you. Fatigue can be caused by many different things, so I will give you an answer in the context of the microbiome. Often, when our digestive system is out of balance, we can develop inflammation in our gut, especially in the context of SIBO. This inflammation has been linked with brain fog and fatigue-like symptoms. I would see if there's a link between your digestive symptoms and your fatigue as a first step. As you address your digestive symptoms, your fatigue could improve in parallel.

Thank you !

-RK